A 40-year-old man with retinal haemangiomas and polycythaemia undergoes contrast MRI brain, which shows a large cystic cerebellar lesion with an intensely enhancing mural nodule abutting the pial surface. The most likely diagnosis is:
- A Medulloblastoma
- B Pilocytic astrocytoma
- C Hemangioblastoma ✓
- D Metastasis from renal cell carcinoma
Correct answer: C. Hemangioblastoma
Explanation
Hemangioblastoma presents in adults as a cystic posterior fossa mass with a vividly enhancing pial-based mural nodule, and is associated with von Hippel-Lindau disease, retinal angiomas and erythropoietin-mediated polycythaemia. Although pilocytic astrocytoma shares the cyst with mural nodule pattern, it occurs in children and lacks the systemic stigmata described here.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.